Think big about mobile health -- going beyond medical records

One of the many miracles that the smartphone has delivered is an entirely new kind of patient. The Empowered Patient is an active manager of his or her health. Once, the Empowered Patient connected with their doctor and managed their health online. Now, with a smartphone in hand, they use mobile apps to connect anytime, anywhere., But these activities seem almost traditional compared with what is to come.

Many people use apps to track their activity during the day, including what they eat, what they drink, and how far they run, walk or climb. All of this data is health information, just as much as a list of vaccinations, medications, or blood test results. This is the next phase of health care: total health, encompassing not just your physiology, but what you eat, what you do, where you live, and the air you breathe. All recorded for you to conveniently track, measure and take action on.

Mobile devices will play a central role in delivering this next phase of health care, and the implications for IT are deep and far-reaching. To me, there are three areas where we need to focus: data access, messaging, and data growth.

Accessible, but safe

Data access is a multidimensional challenge. The concepts of security, availability, and privacy must be applied along several axes: data, applications, and activities. We want to give users access to their personal health information (PHI) anywhere, anytime. But how does one keep that data secure on a device that is often used to broadcast location and activity information about the user, often automatically? The data that Empowered Patients are collecting about their lives and activities is a potential gold mine of information. How do we create safe, secure channels for them to add that information to their electronic health records? Here’s another axis to consider: how should we allow user devices to connect to health care networks and applications that might have other patients’ PHI on them? The new reality is that secured and unsecured apps and networks live side-by-side, and we must take that into account with robust security frameworks.

Getting the message: Guaranteed

The second area where we must focus is on creating robust mobile messaging platforms. To date, “messaging” usually means email and text messages. More recently, it includes social media. But as we think about the Empowered Patient and total health, we need an even broader definition. One approach is to think about how to establish users’ mobile devices as secure, reliable communications channels. To provide a simple example, there are many ways to deliver a medication reminder to a user: in an email or text message, in an automated voicemail, through a dedicated mobile app, or through a mobile browser connection. A holistic mobile messaging platform would classify all of those methods as channels or delivery paths. Meanwhile, the messaging platform would contain an infrastructure that guarantees that the message is delivered securely and reliably—if delivery cannot be confirmed through one channel, the platform would have the intelligence to understand that and try a different channel. Of course, this example only envisions a one-to-one conversation—our secure reliable messaging platform must also take into account social networks and many-to-many conversations.

The more the merrier

The third area where we must focus is data growth. However, the challenge I’m referring to is not about volume, but rather sources and types. My CEO at Kaiser Permanente, George Halvorson, has spoken about having “all of the information about all of the patients, all of the time.” As we look to the future, the definition of “health” information becomes much broader. It encompasses our physiological health, the genetics that we inherit, the environment we live in, and the social circles that we interact with. The perfect system needs to capture markers from each of these, correlate them, mine meaningful information and then share that data with the patient in a consumable form.

The mobile revolution helps the Empowered Patient become an active participant in the health conversation, provides access to health information anywhere and anytime, and dramatically expands the very definition of “health information.” What challenges, gaps and opportunities do you see for building the platforms to support the Empowered Patient?

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